Abstract
Introduction
Subchondral insufficiency fracture of the femoral head (SIF) is a recently proposed concept. It is generally seen in elderly people, however, some young adults have also been reported to suffer from this fracture. The purpose of this study was to investigate the clinical results of a transtrochanteric anterior rotational osteotomy (ARO) performed in young adults with SIF.
Methods
This study focused on young SIF cases (age range from 10 to 29 years). Five patients were diagnosed to have SIF at our institution and conservative treatment was initially performed. The symptoms resolved in 1 case while the other 4 cases showed progression of a collapse. In these 4 cases, ARO was performed, since the fractured area was located in the anterosuperior portion of the femoral head. The average age of the patients was 22 years (range, 16 to 29 years) at the time of surgery, consisting of 2 men and 2 women.
Results
All cases were followed-up and the average follow-up period was 3.4 years (range, 1.8 to 6.8 years). The average preoperative Harris hip score was 67 points, which improved to an average of 93 points at the latest follow-up. Radiographically, the fractured lesion healed and no progression of a collapse was observed in any of the 4 cases.
Conclusion
In the majority of SIF cases, only the anterosuperior portion of the femoral head is involved by the fracture. When considering the optimal surgical treatments for SIF, ARO may be one of the useful options, especially for the treatment of young patients.
